While the origins of natural medicine and therapies can be traced back more than 2500 years ago to ancient China, many Australians are today turning to complementary treatments to boost their health.

Natural medicine, also known as complementary or alternative medicine, is a burgeoning industry.

At least two out of every three Australians use some form of complementary medicine, while a survey found usage rates as high as 87 per cent among some patient groups, such as women with breast cancer.

The sector is also home to an increasing number of practitioners, spanning disciplines ranging from acupuncture and aromatherapy to Ayurvedic medicine, Chinese herbal medicine, chiropractic, osteopathy, myotherapy, naturopathy, shiatsu, homoeopathy, nutrition, musculoskeletal therapy, oriental remedial massage therapy and Western herbal medicine.

The peak professional body, the Australian Natural Therapists Association, has a membership of 10,000 accredited practitioners nationally while three professions - chiropractic (which has 5167 practitioners), osteopathy (with 2094 practitioners ) and Chinese medicine (with 4825 practitioners including acupuncturists, herbal dispensers and herbal medicine practitioners) are now regulated under the Australian Health Practitioner Regulation Agency (AHPRA).

Despite health care consumers embracing alternatives to conventional medicine, little scientific evidence exists to prove the benefits of most natural medicine and therapies.

While a range of modern drugs, such as aspirin, are created from herbs, many health practitioners in the conventional medical professions consider natural medicine and therapies a grey area until they can be underpinned by strong scientific, not anecdotal, evidence.

An evidence base

The Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), at the University of Technology, Sydney (UTS), is working to sort out the fact from the fiction.

The critical public health research centre is leading scientific investigation of complementary and integrative medicine use and practice, spanning areas such as rural and urban health, women’s health, ageing, chronic illness, cancer care and traditional/Indigenous medicine.

The centre is also examining workforce and professional practice issues right through to primary health care and health policy, regulation and legislative issues.

ARCCIM director Jon Adams, a Professor of Public Health and ARC Professorial Future Fellow, says the centre is involved in more than 40 research projects, subjecting complementary health care to critical scientific investigation, in Australia and overseas.

Professor Adams says it’s time we knew more about this booming area of the health sector.

“If you ignore complementary medicine, the realities of its use and practice, and the fact that it already exists and it’s prevalent, you are opening yourself up to actually not doing good service to patients, patient outcomes and efficient health care because you are not informed,” he says.

Professor Adams says while most people question whether natural medicine and therapies work, are effective and safe, there are other questions that also need answers.

“If people are using complementary therapies and medicines in the community, and they are at very high prevalences, then actually there are public health and health service issues that we need to address straight away,” he says.

“They are - how are they using them, do they use them with good evidence, how do they make good decisions about using them or not using them, and do they inform conventional health care providers like doctors and other people in the hospital system about their use of complementaries and other practices?

“So instantly, as far as I’m concerned, there’s a whole agenda there that has been, until very recently, pretty much ignored or missed.

“What we’re doing is we’re not suggesting that the question of - does it work - is irrelevant, far from it. That is highly relevant, everything needs an evidence base.

“The point is, if all we ask is - does it work - then we’re not really, truly understanding what are the behaviours, the decision-making, the information seeking, and the practices that are actually currently going on right now.”

ARCCIM has completed a large study examining almost 2000 pregnant Australian women and their use of complementary medicine and practices.

It found about 60 per cent of pregnant women will visit a complementary medicine practitioner, such as an acupuncturist, chiropractor, naturopath, reflexologist or massage therapist, while between 80 and 90 per cent of pregnant women access complementary medicine throughout the pregnancy and labour process.

“This is one example of information that we didn’t yet have that’s highly scientific and empirical so we can inform other people in the health care system, in this case obstetricians, midwives, the families, the women themselves, about what’s going on in this space because most people only have anecdotal evidence,” Professor Adams says.

Integrating natural with conventional medicine

While some studies have shown the benefits of complementary treatment, such as acupuncture for treating several types of chronic pain, including back and neck pain, osteoarthritis, chronic headache and shoulder pain, the scientific evidence for many natural medicines and therapies is still evolving.

In Australia, most natural medicine and therapies exist outside of the medical health care system.

Professor Adams says despite the clear divide, there are some pockets of movement towards integrating natural medicines and therapies with our conventional, Western model.

Some acupuncturists are now working in health clinics while some GPs are also providing acupuncture as medical acupuncturists.

“There are some GPs who are very open-minded about these complementaries - offering them to patients and talking to patients about them and maybe even informally referring people to these therapists and medicines,” Professor Adams says.

“The seeds of integration are there but it’s very ad hoc and localised.”

Regardless of whether practitioners approve or disapprove of natural medicine and therapies, Professor Adams says they need to discuss complementary medicine and therapies with their patients.

“We know from empirical data that patients don’t often offer that information but we know that providers don’t often inquire about it either, and that’s where the beginning of a breakdown can happen or the beginning of not having all the information to coordinate that patient’s care effectively can happen,” he says.

“Just talk about it. It doesn’t mean you have to refer people, it doesn’t mean you have to be positive about it and think it’s a brilliant thing, of course not - every treatment and every system of medicine needs to be judged on good empirical, rigorous, scientifically collected data but you need to be open to that conversation.

“That is a good starting place for making sure that practitioners are more informed about everything that patients are undertaking and using.”